TY - JOUR
T1 - Race/ethnicity and outcomes following inpatient rehabilitation for hip fracture
AU - Graham, James E.
AU - Chang, Pei Fen J.
AU - Bergés, Ivonne Marrie
AU - Granger, Carl V.
AU - Ottenbacher, Kenneth J.
N1 - Funding Information:
ACKNOWLEDGMENTS This research was supported by funding from the National Institutes of Health (grants R01-AG17638 and K02-AG019736 to K. Ottenbacher). J. E. Graham was supported by a fellowship from the National Institute on Disability and Rehabilitation Research (H133P040003) from the U.S. Department of Education. The funding source had no role in the design of the study, collection, analysis or interpretation of the data, or in the decision to prepare and submit the manuscript for publication. The FIM instrument and UDSMR are trademarks of Uniform Data System for Medical Rehabilitation, a division of UB Foundation Activities, Inc.
PY - 2008/8
Y1 - 2008/8
N2 - Background. Hip fracture results in severe and often permanent reductions in overall health and quality of life for many older adults. As the U.S. population grows older and more diverse, there is an increasing need to assess and improve outcomes across racial/ethnic cohorts of older hip fracture patients. Methods. We examined data from 42,479 patients receiving inpatient rehabilitation for hip fracture who were discharged in 2003 from 825 facilities across the United States. Outcomes of interest included length of stay, discharge setting, and functional status at discharge and 3- to 6-month follow-up. Results. Mean age was 80.2 (standard deviation [SD] = 8.0) years. A majority of the sample was non-Hispanic white (91%), followed by non-Hispanic black (4%), Hispanic (4%), and Asian (1%). After controlling for sociodemographic factors and case severity, significant (p < .05) differences between the non-Hispanic white and minority groups were observed for predicted lengths of stay in days (Asian: 1.1; 95% confidence interval [CI], 0.5-1.7; non-Hispanic black: 0.8; 95% CI, 0.6-1.1), odds of home discharge (Asian: 2.1; 95% CI, 1.6-2.8; non-Hispanic black: 2.0; 95% CI, 1.8-2.3; Hispanic: 1.9; 95% CI, 1.6-2.2), lower discharge Functional Independence Measure (FIM) ratings (non-Hispanic black: 3.6; 95% CI, 3.0-4.2; Hispanic: 1.6; 95% CI, 0.9-2.2 points lower), and lower follow-up FIM ratings (Hispanic: 4.4; 95% CI, 2.8-5.9). Conclusions. Race/ethnicity differences in outcomes were present in a national sample of hip fracture patients following inpatient rehabilitation. Recognizing these differences is the first step toward identifying and understanding potential mechanisms underlying the relationship between race/ethnicity and outcomes. These mechanisms may then be addressed to improve hip fracture care for all patients.
AB - Background. Hip fracture results in severe and often permanent reductions in overall health and quality of life for many older adults. As the U.S. population grows older and more diverse, there is an increasing need to assess and improve outcomes across racial/ethnic cohorts of older hip fracture patients. Methods. We examined data from 42,479 patients receiving inpatient rehabilitation for hip fracture who were discharged in 2003 from 825 facilities across the United States. Outcomes of interest included length of stay, discharge setting, and functional status at discharge and 3- to 6-month follow-up. Results. Mean age was 80.2 (standard deviation [SD] = 8.0) years. A majority of the sample was non-Hispanic white (91%), followed by non-Hispanic black (4%), Hispanic (4%), and Asian (1%). After controlling for sociodemographic factors and case severity, significant (p < .05) differences between the non-Hispanic white and minority groups were observed for predicted lengths of stay in days (Asian: 1.1; 95% confidence interval [CI], 0.5-1.7; non-Hispanic black: 0.8; 95% CI, 0.6-1.1), odds of home discharge (Asian: 2.1; 95% CI, 1.6-2.8; non-Hispanic black: 2.0; 95% CI, 1.8-2.3; Hispanic: 1.9; 95% CI, 1.6-2.2), lower discharge Functional Independence Measure (FIM) ratings (non-Hispanic black: 3.6; 95% CI, 3.0-4.2; Hispanic: 1.6; 95% CI, 0.9-2.2 points lower), and lower follow-up FIM ratings (Hispanic: 4.4; 95% CI, 2.8-5.9). Conclusions. Race/ethnicity differences in outcomes were present in a national sample of hip fracture patients following inpatient rehabilitation. Recognizing these differences is the first step toward identifying and understanding potential mechanisms underlying the relationship between race/ethnicity and outcomes. These mechanisms may then be addressed to improve hip fracture care for all patients.
KW - Ethnic groups
KW - Hip fractures
KW - Outcomes
KW - Rehabilitation
UR - http://www.scopus.com/inward/record.url?scp=53349173397&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=53349173397&partnerID=8YFLogxK
U2 - 10.1093/gerona/63.8.860
DO - 10.1093/gerona/63.8.860
M3 - Article
C2 - 18772475
AN - SCOPUS:53349173397
SN - 1079-5006
VL - 63
SP - 860
EP - 866
JO - Journals of Gerontology - Series A Biological Sciences and Medical Sciences
JF - Journals of Gerontology - Series A Biological Sciences and Medical Sciences
IS - 8
ER -